Zimmerman Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ZIMMERMAN CHIROPRACTIC CLINIC PC

Practice address

7 E Main St
Du Quoin, IL 62832-1420

Phone

(618) 542-2165

Fax

(618) 542-9276

NPI assigned

Sep 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard Wayne Zimmerman, DC, CCSP.NPI 1790891273

Title

Chiropractor/Owner

Phone

(618) 542-2165

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard W Zimmerman, D.C.

  • Chiropractor
  • Du Quoin, IL
  • NPI 1790891273
  Medicare reassignment NPD Authorized official
• Sheila Sue Decker, D.C.

  • Chiropractor
  • Gulf Breeze, FL
  • NPI 1326334426
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1396053005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 E MAIN ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628321420",
            "telephone_number": "618-542-2165",
            "fax_number": "618-542-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 E MAIN ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628321420",
            "telephone_number": "618-542-2165",
            "fax_number": "618-542-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZIMMERMAN CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "618-542-2165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, CCSP."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038007421",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07308609",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda Lynne Wilson, RN, PMHNP-BC
• David F Woods, HIS
• Bruce T Wreath, CRNA
• Nicole M Wynn
• Saeed Zamir, M.D.
• Richard W Zimmerman, D.C.

• Chiropractor in Du Quoin, IL
• Providers in Du Quoin, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.